Healthcare Provider Details

I. General information

NPI: 1598942849
Provider Name (Legal Business Name): DR. MACKEY'S FAMILY CHIROPRACTIC, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BAUGHMAN AVE. SUITE B
DANVILLE KY
40422
US

IV. Provider business mailing address

PO BOX 356
DANVILLE KY
40423-0356
US

V. Phone/Fax

Practice location:
  • Phone: 859-238-9300
  • Fax: 859-238-9977
Mailing address:
  • Phone: 859-238-9300
  • Fax: 859-238-9977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4129
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4129
License Number StateKY

VIII. Authorized Official

Name: CRAIG MACKEY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 859-238-9300